Individual provider Active NPI

Renee Vansickle, ARNP

  • Nurse Practitioner
  • Winchester, VA
National Provider Identifier
1194120709
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP 9170935 Issued in FL
Practice address
1330 Amherst St Ste C
Winchester, VA 22601-3000
Phone
(540) 722-2369
Fax
(540) 722-6601
NPI assigned
Oct 24, 2014
Last updated
Jul 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP 9170935 FL Primary

Addresses

Primary practice location

1330 Amherst St Ste C
Winchester, VA 22601-3000

Mailing address

PO Box 1146
Martinsburg, WV 25402-1146
Phone (304) 263-4999

Other identifiers 1

IdentifierTypeStateIssuer
ARNP9170935OtherFLSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210930000013 VA Practitioner - Nurse Practitioner 9830411727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1330 Amherst St
Winchester, VA 22601-3054
Phone 30426349991063

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP 9170935FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shenandoah Valley Medical System, Inc. CurrentSince Sep 20, 2021 Accepting new patients
Shenandoah Valley Medical System, Inc. Current Accepting new patients
Shenandoah Valley Medical System, Inc. CurrentSince Sep 20, 2021 Accepting new patients
Shenandoah Valley Medical System, Inc. Past Accepting new patients

Locations

1330 Amherst St
Winchester, VA 22601
Phone (540) 662-0711

1330 Amherst St
Ste C
Winchester, VA 22601
Phone (540) 662-6400

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: renee.van.sickle.1@32629.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1194120709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1146",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254021146",
            "telephone_number": "304-263-4999",
            "fax_number": "352-260-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 AMHERST ST STE C",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226013000",
            "telephone_number": "540-722-2369",
            "fax_number": "540-722-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANSICKLE",
        "first_name": "RENEE",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-24",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP 9170935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "ARNP9170935",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

Verify at the official NPI Registry.